78 Questions
What is the forceful expulsion of stomach contents from the mouth due to involuntary contractions of the abdominal, thoracic and GI (smooth) muscles?
Vomiting
Which neurotransmitter is involved in the vomiting process?
Serotonin
What is the common cause of acute nausea and vomiting associated with acute abdominal pain in adults?
Acute Pancreatitis
Which metabolic disease is a cause of chronic nausea and vomiting in adults?
Hyperthyroidism
Which medication is reported to have vomiting as a side effect in more than 5% of the cases?
Opioids
What is the term for the relaxation of the pyloric sphincter that guards the lower end of the stomach to bring up content from the gut?
Abdominal pressure rise
What condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?
Retching
What is the main cause of chronic diarrhea in patients with pancreatic insufficiency?
Bacterial overgrowth
Which virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?
Cytomegalovirus
What is the main symptom associated with osmotic diarrhea?
Cramping
What dietary recommendation is important for patients experiencing chronic diarrhea?
Gradual reinsertion of all foods
What is the most appropriate treatment for moderate to severe travelers' diarrhea with fever, blood, pus, or mucus in the stool?
Empiric antibiotic therapy
What is the main diagnostic approach for differentiating chronic diarrhea sub-types such as osmotic, secretory, and motility-induced diarrhea?
Stool electrolytes and osmolality
What is the common cause of dysmotility diarrhea known as 'overflow' diarrhea?
Colon cancer
What is the first step in the physical examination of a patient presenting with acute abdominal pain?
Systematic physical examination
In the context of acute abdominal pain, which imaging modality is useful for renal stones but is not the primary investigation?
Ultrasound
What is the most common surgical cause of acute abdominal pain in elderly patients?
Acute appendicitis
What is the commonest cause of acute abdominal pain in women of childbearing age?
Acute appendicitis
How is diarrhea defined?
Three or more loose or watery stools per day
What are key questions to ask during history taking for acute diarrhea?
Duration and presence of mucus, pus, or blood
Which is responsible for most cases of severe diarrhea?
Bacteria
What is the general approach to evaluating acute diarrhea?
Careful history to determine symptoms' duration and characteristics
Which stage of nutrient absorption involves the final transport of absorbed nutrients into the general circulation?
Transport into the circulation
What is the term for recurrent, frequent, uncontrolled leakage of stool and/or stool staining for more than 1 month?
Incontinence
What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?
Lactase
In the context of constipation, what does the absence of anal wink reflex suggest?
Pelvic floor dysfunction
What is defined as constipation that includes a constellation of symptoms such as excessive straining, a sense of incomplete evacuation, and abdominal bloating?
Chronic constipation
What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?
Obstruction in the lymphatic system
According to the text, what is a possible cause of lymphatic obstruction that can lead to impaired absorption of lipoproteins?
Primary intestinal lymphangiectasis
What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?
Malabsorption disorder
Which condition is characterized by strong, involuntary vomiting associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?
Cyclic vomiting syndrome
What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?
Cytomegalovirus
What dietary recommendation is important for patients experiencing chronic diarrhea?
Avoid dairy products
What is the common cause of dysmotility diarrhea known as 'overflow' diarrhea?
Small intestine bacterial overgrowth (SIBO)
What is the main symptom associated with osmotic diarrhea?
Greasy or oily stools
Which neurotransmitter is involved in the vomiting process?
Serotonin
What is the term for the relaxation of the pyloric sphincter that guards the lower end of the stomach to bring up content from the gut?
Rumination syndrome
Which metabolic disease is a cause of chronic nausea and vomiting in adults?
Addison's disease
Which neurotransmitter is NOT involved in the vomiting process?
Acetylcholine
What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?
Cytomegalovirus
What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?
Lactase
What is the main cause of chronic diarrhea in patients with pancreatic insufficiency?
Impaired fat digestion
What dietary recommendation is important for patients experiencing chronic diarrhea?
Increase fiber intake
Which medication is reported to have vomiting as a side effect in more than 5% of the cases?
Opioids
What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?
Maldigestion
In the context of constipation, what does the absence of anal wink reflex suggest?
'Neurogenic' constipation
Which condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?
Cyclic vomiting syndrome
What is the enzyme present in the brush border membrane of the small intestine responsible for hydrolyzing lactose found in mammalian milk?
Lactase
What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?
Pancreatitis
What is defined as constipation that includes a constellation of symptoms such as excessive straining, a sense of incomplete evacuation, and abdominal bloating?
Irritable bowel syndrome (IBS)
Which neurotransmitter is involved in the vomiting process?
Serotonin
What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?
Cytomegalovirus
What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?
Maldigestion
What is the most common surgical cause of acute abdominal pain in elderly patients?
Mesenteric ischemia
What is the term for a decrease in gut absorptive function not requiring iv supplementation for health and/or growth maintenance?
Intestinal insufficiency
Which enzyme, present in the brush border membrane of the small intestine, is responsible for hydrolyzing lactose found in mammalian milk?
Lactase
What does the term 'lactose malabsorption' refer to?
Low lactase activity without symptoms
What can impair the absorption of lipoproteins and lead to fat malabsorption, steatorrhea, and chylous ascites?
Primary intestinal lymphangiectasis
What is the term for infrequent, difficult passage of stool with the sensation of incomplete bowel emptying?
Constipation
What neurotransmitter is involved in the vomiting process?
Serotonin
What is the term for recurrent, frequent, uncontrolled leakage of stool and/or stool staining for more than 1 month?
Incontinence
What refers to deficiencies in the process of both absorption and digestion, even though malabsorption and maldigestion differ pathophysiologically?
Intestinal insufficiency
Which pathogen is responsible for symptoms that begin within six hours after ingestion and suggest ingestion of a preformed toxin?
Staphylococcus aureus
What is the appropriate initial work-up for differentiating osmotic diarrhea from secretory diarrhea?
Stool osmolality and pH
In which condition would loperamide (Imodium) be contraindicated as symptomatic treatment?
Bacterial diarrhea with fever and bloody diarrhea
Which diagnostic approach is usually NOT needed for distinguishing between inflammatory bowel disease (IBD) and infectious diarrhea?
Endoscopy
What dietary recommendation is important for patients with chronic diarrhea to ensure adequate nutrition?
Gradual reinsertion of all foods
What is the underlying cause of osmotic diarrhea?
Defects in ion absorption
Which condition may present with greasy, floating stools as a symptom?
Pancreatic insufficiency
"Overflow" diarrhea is often associated with which of the following conditions?
Fecal incontinence
What is the first step in evaluating a patient with acute abdominal pain?
Physical examination
What is the most common cause of acute abdominal pain in women of childbearing age?
Gynecologic complaints
What condition involves a strong, involuntary, unproductive effort to vomit associated with abdominal muscle contraction but without expulsion of gastric contents through the mouth?
Dry heaves
What is the main symptom associated with osmotic diarrhea?
Foul-smelling, floating stools
Which imaging modality is accurate for renal colic, appendicitis, diverticulitis, AAA, and intra-abdominal abscesses?
Computer tomography (CT)
What virus can cause acute diarrhea in immunocompromised patients, particularly those with AIDS?
Cytomegalovirus
What neurotransmitter is involved in the vomiting process?
Serotonin
What is defined as diarrhea that is painless and involves loose or watery stools during ≥75% of defecations for the prior 3 months?
Chronic diarrhea
This quiz covers systematic physical examination techniques including abdominal exam, digital rectal examination, pelvic exam, genito-urinary examination, musculoskeletal examination. It also includes information about bedside observations and a range of laboratory tests such as CBC, electrolytes, BUN, Cr, coagulation, amylase, lipase, and LFTs.
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